Jessica Shane Rose Julia Esquivel

Individual provider Active NPI Personal Care Attendant · Lost Creek, WV

NPI 1104672492 · NPPES record last updated Apr 26, 2024

Key facts

NPI
1104672492
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
8894 Good Hope Pike
Lost Creek, WV 26385-6934
Phone
(304) 695-9539
NPI assigned
Apr 26, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

8894 Good Hope Pike
Lost Creek, WV 26385-6934

Mailing address

8894 Good Hope Pike
Lost Creek, WV 26385-6934
Phone (304) 695-9539

Other providers in Lost Creek, WV

All providers in Lost Creek, WV · Personal Care Attendant in West Virginia

Sources for this page

Verify at the official NPI Registry.